AIM: To investigate the clinical effect of phacoemulsification and intraocular lens ( IOL ) implantation for cataract patients after corneal refractive surgery, and to compare the accuracy of the different refractive IOL.
METHODS:The data of 120 myopia cases (160 eyes) in our hospital, who underwent cataract surgery and corneal refractive surgery were analyzed. Corneal curvature K value before corneal refractive surgery were obtained and calculated by using history method. Corneal curvature correction numerical method and corneal topography were used to record K value of patients with incomplete data before and after treatment. The K value was substituted into the formula. By comparing the actual cataract surgery and refractive state expected refractive status (-0. 50D), the accuracy of IOL refractive obtained from three methods was compared.
RESULTS: The average best corrected visual acuity before cataract surgery was 0. 25 ± 0. 05, and it was improved ( 0. 80 ± 0. 05 ) after surgery. The average spherical equivalent (SE) was -1. 98±1. 75 before surgery and +0.85±3.38 after surgery (P<0.05). The K values of 48 cases were calculated by clinical history method ( CHM ) and that of 73 cases was calculated with the adjusted keratometry method ( AKM) . The K values of 39 cases were calculated using the corneal topography method ( CTM) .
CONCLUSION: For patients with corneal refractive surgery, the appropriate method can be selected according to clinical symptoms, history, etc. and this may help to accurately calculate IOL. For patients with complete data, CHM can be used to provide corneal K values, while for those with incomplete data, AKM and CHM can be used.

Payment system reforms have become an important part of Chinese healthcare reforms, and global budget has been seen as a major trend. Based on the practice and data of four pilot hospitals in Beijing which have implemented the global budget, this paper focuses on analyzing the effects of implementation on the following aspects and provides references for policy improvements: medical services, average medical cost, total health expenditure, medical cost structure, average length of stay and out-of-pocket expense percentages.

Medical metrology work is the base of quality control for hospital medical equipment.It guarantees the accuracy of hospital medical instruments.It is important to set up a complete management system for hospital metrology institutions.

Objective:To study the relationships between age,the state of genital tract and vaginitis,cervical erosion and vulvae leukoplakia in married women.Methods:Gynecologic inspection and laboratory examination were performed in 1 253 patients diagnosed vaginitis,cervicitis and vulvae leukoplakia in a women screen in a certain area in Chongqing in 2007.Statistics analysis was made by SAS8.1.Results:Of 1 253 patiens,45.89% had vaginitis,44.69%,cervical erosion,and 3.35%,vulvae leukoplakia,6.07%,the other conditions.Age,vaginal cleanness degree,candida infection were risk factors of vaginitis;Age,vaginal cleanness degree were related to cervical erosion and vulvae leukoplakia.Conclusion:Vaginitis,cervical erosion and vulvae leukoplakia should arouse more attention in the prevention and treatment of women genital tract disease in the future,and the standard etiology treatment should be performed to get microcosmic ecological balance.The perfect control and monitoring system for gynecologic disease should be established,and service quality of women health care should be improved.

Objectives To explore the effects of control measures and dynamic prevalence of drinking water endemic fluorosis in China, to provide basis and technique support for endemic fluorosis control in China. Methods The survey was carried out according to the national surveillance Scheme of Endemic Fuorosis. The fulfillment of control measures and the quality of water improving projects were surveyed. Household water sample and urine of children aged 8-12 years were collected and fluoride content was detected by iron selective electrode method. Check the teeth of children aged 8-12 years. Dental fluorosis was diagnosed by Dean's method. Results projects were build in 84 endemic villages in 2006, and the average water improving rate came to 73.98% fluoride contents of half the surveyed spots were over the standard, mainly between 1.0-2.0 mg/L, and the urine controlled just in only few spots and it was in moderate or severe status in some endemic areas for many years. Conclusions Little progress of control measures in drinking water endemic fluorosis counties surveyed has been made in these two years. Projects of running out of status and over standard of water fluorosis are frequently seen. Dental fluorosis in many spots is not controlled.

Humans ; Occupational Diseases ; prevention & control

Teaching is very important for anesthesiology developmemt,so residents should be cultivated the teaching capacity as soon as possible.This article discussed how to cultivate the teaching capacity of residents in anesthesiology department.

OBJECTIVE:To promote effective supervision of key monitoring drugs by provincial pharmaceutical quality control center,and to improve rational drug use. METHODS:The effects of No.2 district of Sichuan province pharmaceutical quality con-trol center on 3 categories of key monitoring drugs guidance and supervision,through urging medical institution in the area to estab-lish key monitoring drugs supervision system,formulating prescription review guideline for 3 categories of key monitoring drugs [TCM injection,adjunctive drug,proton pump inhibitors (PPIs)],developing baseline data survey,inspecting the application of key monitoring drug in medical instaurations on the spot and other measures,were introduced. Through collecting the reports of re-gional quality control center to the provincial quality control center,supervision system of medical institutions were analyzed statisti-cally. Key monitoring drugs of medical institutions in the area were analyzed statistically in respects of rational utilization ratio,uti-lization quantity,utilization amount,etc.,so as to evaluate supervision effects. RESULTS:Up to Apr. 2016,92.26%medical insti-tutions had been aware of the relevant requirements of the documents;84.25% had established the hospital supervision system. 3 categories of key monitoring drugs prescription(orders)comment guideline had been developed in Mar. 2016. 18 third-grade class-A general medical institutions were randomly selected;among 3 categories,irrational utilization ratio of TCM injection decreased by 12.35%(35.41% vs. 47.76%);that of adjunctive drugs decreased by 9.64%(20.95% vs. 30.59%);that of PPIs decreased by 7.44%(40.49% vs. 47.93%) in May 2016,compare to Jan. 2016. Average consumption sum of them decreased by 12.07%, 13.30%,9.49%,respectively in Apr. 2016,compared to Jan. 2016. 55.02% medical institutions had started to collect the baseline data. CONCLUSIONS:The provincial pharmaceutical quality control center has played an important role on establishing a supervi-sion system,it can promote the effective supervision by guiding and supervising the medical institutions evaluating the supervision of medical institutions and pointing out the problems.

Medicine is related to people's wellbeing,which is an eternal topic that all mankind concern.Studying on the process from the origin to the development of medicine can figure out the development rules of medicine,gain experience from it,and provide guidance for better development of medicine in the future.Medical anthropology is a new discipline which focuses on the study of disease and culture.From this special perspective,studying on the process from the origin to the development of medicine can help us to have a profound and comprehensive understanding of medicine.This paper reviewed the relevant concepts of medical anthropology and the research status and research characteristics of the origin and development of Chinese and Western Medicine,providing a reference for the colleagues.

Objective To compare the clinical effects of modified single open-door laminoplasty combined with segmental lateral screw fixation with conventional single open-door combined with continuous screw fixation in the treatment of multilevel cervical spondylotic myelopathy (MCSM).Methods Retrospective analysis was used to analyze the fifty-five cases of MCSM who underwent posterior operation in Lianyungang Hospital Affiliated to Xuzhou Medical University from March 2009 to January 2017.Among them,26 cases in the modified group were treated by modified single open-door laminoplasty combined with segmental lateral screw fixation;29 cases in the traditional group were treated by conventional single open-door combined with continuous screw fixation.JOA score collected before the operation and at the last time of the follow-up,the cervical spine mobility,cervical curvature,cervical axial symptom,C5 nerve root palsy and the incidence rate of screw fracture in both groups were compared.Operation time and the intraoperative blood loss were recorded.Results 55 cases were all followed up.The cervical spine mobility at the last time of the follow-up in the modified group was significantly higher than that of the traditional group ((39.63°±5.98°) vs.(36.14°±6.05°),P=0.036).The cervical curvature in the modified group was higher than that of the traditional group ((19.83°±5.61°) vs.(16.02°±7.05°),P=0.030).The operation time and intraoperative blood loss in the modified group were significantly lower than those of the traditional group ((116.3±13.2) min vs.(128.7±14.3) min,(186.7±39.8) ml vs.(228.7±42.5) ml,P=0.002,0.000).In the modified group,the proportion of patients with postoperative cervical axial symptom was 15.38%,the rate of C5 nerve root palsy cases was 8.69%,compared with 48.27% and 34.48%,respectively in the control group,the difference between the two groups was statistically significant (P=0.011,0.022).In the traditional group,2 cases of screw fracture were found at the last follow-up,while there was no such case in the modified group.Conclusion The modified cervical single open-door laminoplasty combined with segmental lateral screw fixation can obtain good effect of nerve decompression,maintain cervical mobility and cervical curvature,reduce the occurrence of postoperative cervical axial symptom,C5 never root palsy,screw fracture and other complications,is a safe and effective surgical method.